Early changes in T-cell activation predict antiretroviral success in salvage therapy of HIV infection.
Early changes in T-cell activation predict antiretroviral success in salvage therapy of HIV infection.
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T 细胞激活的早期变化预示着 HIV 感染抢救治疗中抗逆转录病毒治疗的成功。
DOI：
10.1097/qai.0b013e31816d9c3b
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Badley,AndrewD
中科院分区：
文献类型：
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作者：
Shepard,BrettD;Loutfy,MonaR;Raboud,Janet;Mandy,Frank;Kovacs,ColinM;Diong,Christina;Bergeron,Michele;Govan,Victoria;Rizza,StaceyA;Angel,JonathanB;Badley,AndrewD
目的：由于有效的抗逆转录病毒治疗（ART）减少免疫激活，我们假设，免疫激活的早期变化与随后的病毒学反应therapeutic.Design：观察性队列研究。设置：机构HIV clinic.Subjects：34例成人HIV患者与病毒学失败，对他们目前的抗逆转录病毒therapeutic.Intervention：改变挽救治疗方案，由患者的医生选择。主要结果测量：免疫激活的措施，在基线和在2，4，8，24周后登记。结果：PH模型显示，基线和第2周之间CD 4 + T细胞上CD 38（P= 0.02）或CD 95（P= 0.02）表达的降低与实现病毒学抑制的可能性增加相关。Kaplan-Meier分析表明，在治疗的前2周内CD 4 + T细胞表达CD 38（P= 0.003）或CD 95（P= 0.08）减少的患者更有可能实现病毒抑制比那些谁没有。结论：减少CD 4 + T细胞表达CD 38和CD 95发生在2周内的挽救治疗与随后的病毒抑制。监测CD 38和CD 95可以更早地评估对ART的反应。
Objective:Because effective antiretroviral therapy (ART) reduces immune activation, we hypothesize that early changes in immune activation are associated with subsequent virologic response to therapy.Design:Observational cohort study.Setting:Institutional HIV clinic.Subjects:Thirty-four adult HIV patients with virologic failure on their current antiretroviral regimen.Intervention:Change to salvage regimen selected by patient's physician.Main Outcome Measures:Measures of immune activation at baseline and at 2, 4, 8, and 24 weeks after enrollment. Data were analyzed by proportional hazards (PH) models.Results:PH models showed that reductions between baseline and week 2 in expression of CD38 (P= 0.02) or CD95 (P= 0.02) on CD4+ T cells were associated with increased likelihood of achieving virologic suppression. Kaplan-Meier analysis demonstrated that patients who had reductions within the first 2 weeks of therapy in CD4+ T-cell expression of CD38 (P= 0.003) or CD95 (P= 0.08) were more likely to achieve viral suppression than those who did not.Conclusions:Reduced CD4+ T-cell expression of CD38 and CD95 occurring within 2 weeks of salvage therapy is associated with subsequent viral suppression. Monitoring CD38 and CD95 may allow earlier assessment of the response to ART.